GORDON FEINBLATT LLC has sponsored the creation of one or more 401k plans.
Submission information for form 5500 for 401k plan GORDON FEINBLATT CAFETERIA PLAN
Measure | Date | Value |
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2022: GORDON FEINBLATT CAFETERIA PLAN 2022 401k membership |
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Total participants, beginning-of-year | 2022-05-01 | 67 |
Total number of active participants reported on line 7a of the Form 5500 | 2022-05-01 | 63 |
Number of retired or separated participants receiving benefits | 2022-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2022-05-01 | 0 |
Total of all active and inactive participants | 2022-05-01 | 63 |
2021: GORDON FEINBLATT CAFETERIA PLAN 2021 401k membership |
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Total participants, beginning-of-year | 2021-05-01 | 74 |
Total number of active participants reported on line 7a of the Form 5500 | 2021-05-01 | 67 |
Number of retired or separated participants receiving benefits | 2021-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2021-05-01 | 0 |
Total of all active and inactive participants | 2021-05-01 | 67 |
2020: GORDON FEINBLATT CAFETERIA PLAN 2020 401k membership |
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Total participants, beginning-of-year | 2020-05-01 | 87 |
Total number of active participants reported on line 7a of the Form 5500 | 2020-05-01 | 74 |
Number of retired or separated participants receiving benefits | 2020-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2020-05-01 | 0 |
Total of all active and inactive participants | 2020-05-01 | 74 |
2019: GORDON FEINBLATT CAFETERIA PLAN 2019 401k membership |
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Total participants, beginning-of-year | 2019-05-01 | 101 |
Total number of active participants reported on line 7a of the Form 5500 | 2019-05-01 | 87 |
Number of retired or separated participants receiving benefits | 2019-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2019-05-01 | 0 |
Total of all active and inactive participants | 2019-05-01 | 87 |
2018: GORDON FEINBLATT CAFETERIA PLAN 2018 401k membership |
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Total participants, beginning-of-year | 2018-05-01 | 114 |
Total number of active participants reported on line 7a of the Form 5500 | 2018-05-01 | 101 |
Number of retired or separated participants receiving benefits | 2018-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2018-05-01 | 0 |
Total of all active and inactive participants | 2018-05-01 | 101 |
2017: GORDON FEINBLATT CAFETERIA PLAN 2017 401k membership |
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Total participants, beginning-of-year | 2017-05-01 | 107 |
Total number of active participants reported on line 7a of the Form 5500 | 2017-05-01 | 111 |
Number of retired or separated participants receiving benefits | 2017-05-01 | 3 |
Total of all active and inactive participants | 2017-05-01 | 114 |
Total participants | 2017-05-01 | 114 |
2016: GORDON FEINBLATT CAFETERIA PLAN 2016 401k membership |
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Total participants, beginning-of-year | 2016-05-01 | 117 |
Total number of active participants reported on line 7a of the Form 5500 | 2016-05-01 | 106 |
Number of retired or separated participants receiving benefits | 2016-05-01 | 1 |
Total of all active and inactive participants | 2016-05-01 | 107 |
Total participants | 2016-05-01 | 107 |
2015: GORDON FEINBLATT CAFETERIA PLAN 2015 401k membership |
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Total participants, beginning-of-year | 2015-05-01 | 156 |
Total number of active participants reported on line 7a of the Form 5500 | 2015-05-01 | 116 |
Number of retired or separated participants receiving benefits | 2015-05-01 | 1 |
Total of all active and inactive participants | 2015-05-01 | 117 |
Total participants | 2015-05-01 | 117 |
2014: GORDON FEINBLATT CAFETERIA PLAN 2014 401k membership |
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Total participants, beginning-of-year | 2014-05-01 | 158 |
Total number of active participants reported on line 7a of the Form 5500 | 2014-05-01 | 156 |
Number of retired or separated participants receiving benefits | 2014-05-01 | 2 |
Total of all active and inactive participants | 2014-05-01 | 158 |
Total participants | 2014-05-01 | 158 |
2013: GORDON FEINBLATT CAFETERIA PLAN 2013 401k membership |
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Total participants, beginning-of-year | 2013-05-01 | 167 |
Total number of active participants reported on line 7a of the Form 5500 | 2013-05-01 | 158 |
Total of all active and inactive participants | 2013-05-01 | 158 |
Total participants | 2013-05-01 | 158 |
2012: GORDON FEINBLATT CAFETERIA PLAN 2012 401k membership |
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Total participants, beginning-of-year | 2012-05-01 | 166 |
Total number of active participants reported on line 7a of the Form 5500 | 2012-05-01 | 167 |
Total of all active and inactive participants | 2012-05-01 | 167 |
Total participants | 2012-05-01 | 167 |
2011: GORDON FEINBLATT CAFETERIA PLAN 2011 401k membership |
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Total participants, beginning-of-year | 2011-05-01 | 168 |
Total number of active participants reported on line 7a of the Form 5500 | 2011-05-01 | 166 |
Number of retired or separated participants receiving benefits | 2011-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2011-05-01 | 0 |
Total of all active and inactive participants | 2011-05-01 | 166 |
Total participants | 2011-05-01 | 166 |
2009: GORDON FEINBLATT CAFETERIA PLAN 2009 401k membership |
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Total participants, beginning-of-year | 2009-05-01 | 159 |
Total number of active participants reported on line 7a of the Form 5500 | 2009-05-01 | 187 |
Number of retired or separated participants receiving benefits | 2009-05-01 | 0 |
Number of other retired or separated participants entitled to future benefits | 2009-05-01 | 0 |
Total of all active and inactive participants | 2009-05-01 | 187 |
Total participants | 2009-05-01 | 187 |
2022: GORDON FEINBLATT CAFETERIA PLAN 2022 form 5500 responses |
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2022-05-01 | Type of plan entity | Single employer plan |
2022-05-01 | Submission has been amended | No |
2022-05-01 | This submission is the final filing | No |
2022-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2022-05-01 | Plan is a collectively bargained plan | No |
2022-05-01 | Plan funding arrangement – Insurance | Yes |
2022-05-01 | Plan benefit arrangement – Insurance | Yes |
2021: GORDON FEINBLATT CAFETERIA PLAN 2021 form 5500 responses |
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2021-05-01 | Type of plan entity | Single employer plan |
2021-05-01 | Submission has been amended | No |
2021-05-01 | This submission is the final filing | No |
2021-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2021-05-01 | Plan is a collectively bargained plan | No |
2021-05-01 | Plan funding arrangement – Insurance | Yes |
2021-05-01 | Plan benefit arrangement – Insurance | Yes |
2020: GORDON FEINBLATT CAFETERIA PLAN 2020 form 5500 responses |
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2020-05-01 | Type of plan entity | Single employer plan |
2020-05-01 | Submission has been amended | No |
2020-05-01 | This submission is the final filing | No |
2020-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2020-05-01 | Plan is a collectively bargained plan | No |
2020-05-01 | Plan funding arrangement – Insurance | Yes |
2020-05-01 | Plan benefit arrangement – Insurance | Yes |
2019: GORDON FEINBLATT CAFETERIA PLAN 2019 form 5500 responses |
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2019-05-01 | Type of plan entity | Single employer plan |
2019-05-01 | Submission has been amended | No |
2019-05-01 | This submission is the final filing | No |
2019-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2019-05-01 | Plan is a collectively bargained plan | No |
2019-05-01 | Plan funding arrangement – Insurance | Yes |
2019-05-01 | Plan benefit arrangement – Insurance | Yes |
2018: GORDON FEINBLATT CAFETERIA PLAN 2018 form 5500 responses |
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2018-05-01 | Type of plan entity | Single employer plan |
2018-05-01 | Submission has been amended | No |
2018-05-01 | This submission is the final filing | No |
2018-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2018-05-01 | Plan is a collectively bargained plan | No |
2018-05-01 | Plan funding arrangement – Insurance | Yes |
2018-05-01 | Plan benefit arrangement – Insurance | Yes |
2017: GORDON FEINBLATT CAFETERIA PLAN 2017 form 5500 responses |
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2017-05-01 | Type of plan entity | Single employer plan |
2017-05-01 | Submission has been amended | No |
2017-05-01 | This submission is the final filing | No |
2017-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2017-05-01 | Plan is a collectively bargained plan | No |
2017-05-01 | Plan funding arrangement – Insurance | Yes |
2017-05-01 | Plan benefit arrangement – Insurance | Yes |
2016: GORDON FEINBLATT CAFETERIA PLAN 2016 form 5500 responses |
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2016-05-01 | Type of plan entity | Single employer plan |
2016-05-01 | Submission has been amended | No |
2016-05-01 | This submission is the final filing | No |
2016-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2016-05-01 | Plan is a collectively bargained plan | No |
2016-05-01 | Plan funding arrangement – Insurance | Yes |
2016-05-01 | Plan benefit arrangement – Insurance | Yes |
2015: GORDON FEINBLATT CAFETERIA PLAN 2015 form 5500 responses |
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2015-05-01 | Type of plan entity | Single employer plan |
2015-05-01 | Submission has been amended | No |
2015-05-01 | This submission is the final filing | No |
2015-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2015-05-01 | Plan is a collectively bargained plan | No |
2015-05-01 | Plan funding arrangement – Insurance | Yes |
2015-05-01 | Plan benefit arrangement – Insurance | Yes |
2014: GORDON FEINBLATT CAFETERIA PLAN 2014 form 5500 responses |
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2014-05-01 | Type of plan entity | Single employer plan |
2014-05-01 | Submission has been amended | No |
2014-05-01 | This submission is the final filing | No |
2014-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2014-05-01 | Plan is a collectively bargained plan | No |
2014-05-01 | Plan funding arrangement – Insurance | Yes |
2014-05-01 | Plan benefit arrangement – Insurance | Yes |
2013: GORDON FEINBLATT CAFETERIA PLAN 2013 form 5500 responses |
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2013-05-01 | Type of plan entity | Single employer plan |
2013-05-01 | Submission has been amended | No |
2013-05-01 | This submission is the final filing | No |
2013-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2013-05-01 | Plan is a collectively bargained plan | No |
2013-05-01 | Plan funding arrangement – Insurance | Yes |
2013-05-01 | Plan benefit arrangement – Insurance | Yes |
2012: GORDON FEINBLATT CAFETERIA PLAN 2012 form 5500 responses |
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2012-05-01 | Type of plan entity | Single employer plan |
2012-05-01 | Submission has been amended | No |
2012-05-01 | This submission is the final filing | No |
2012-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2012-05-01 | Plan is a collectively bargained plan | No |
2012-05-01 | Plan funding arrangement – Insurance | Yes |
2012-05-01 | Plan benefit arrangement – Insurance | Yes |
2011: GORDON FEINBLATT CAFETERIA PLAN 2011 form 5500 responses |
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2011-05-01 | Type of plan entity | Single employer plan |
2011-05-01 | Submission has been amended | No |
2011-05-01 | This submission is the final filing | No |
2011-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2011-05-01 | Plan is a collectively bargained plan | No |
2011-05-01 | Plan funding arrangement – Insurance | Yes |
2011-05-01 | Plan benefit arrangement – Insurance | Yes |
2009: GORDON FEINBLATT CAFETERIA PLAN 2009 form 5500 responses |
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2009-05-01 | Type of plan entity | Single employer plan |
2009-05-01 | Submission has been amended | No |
2009-05-01 | This submission is the final filing | No |
2009-05-01 | This return/report is a short plan year return/report (less than 12 months) | No |
2009-05-01 | Plan is a collectively bargained plan | No |
2009-05-01 | Plan funding arrangement – Insurance | Yes |
2009-05-01 | Plan benefit arrangement – Insurance | Yes |
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) |
Policy contract number | 1WDY |
Policy instance | 1 |
Insurance contract or identification number | 1WDY | Number of Individuals Covered | 63 | Insurance policy start date | 2022-05-01 | Insurance policy end date | 2023-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $31,561 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,005,466 | Amount paid for insurance broker fees | 31561 | Additional information about fees paid to insurance broker | PERSISTENCY BONUS PRODUCER SERVICE FEE | Insurance broker organization code? | 3 |
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CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) |
Policy contract number | 1WDY |
Policy instance | 1 |
Insurance contract or identification number | 1WDY | Number of Individuals Covered | 67 | Insurance policy start date | 2021-05-01 | Insurance policy end date | 2022-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $34,658 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $940,742 | Amount paid for insurance broker fees | 34658 | Additional information about fees paid to insurance broker | PERSISTENCY BONUS PRODUCER SERVICE FEE | Insurance broker organization code? | 3 |
|
CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) |
Policy contract number | 1WDY |
Policy instance | 1 |
Insurance contract or identification number | 1WDY | Number of Individuals Covered | 74 | Insurance policy start date | 2020-05-01 | Insurance policy end date | 2021-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $28,915 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $937,645 | Amount paid for insurance broker fees | 28915 | Additional information about fees paid to insurance broker | PERSISTENCY BONUS PRODUCER SERVICE FEE | Insurance broker organization code? | 3 |
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CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) |
Policy contract number | 1WDY |
Policy instance | 1 |
Insurance contract or identification number | 1WDY | Number of Individuals Covered | 87 | Insurance policy start date | 2019-05-01 | Insurance policy end date | 2020-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $33,732 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $984,545 | Amount paid for insurance broker fees | 33732 | Additional information about fees paid to insurance broker | PERSISTENCY BONUS PRODUCER SERVICE FEE | Insurance broker organization code? | 3 |
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CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) |
Policy contract number | 1WDY |
Policy instance | 1 |
Insurance contract or identification number | 1WDY | Number of Individuals Covered | 101 | Insurance policy start date | 2018-05-01 | Insurance policy end date | 2019-04-30 | Total amount of commissions paid to insurance broker | USD $26,323 | Total amount of fees paid to insurance company | USD $19,832 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,052,819 | Commission paid to Insurance Broker | USD $26,323 | Amount paid for insurance broker fees | 19832 | Additional information about fees paid to insurance broker | MEDICAL CONTRACTS NON-MONETARY INCENTIVE AMOUNT WHOLESALER FEE | Insurance broker organization code? | 3 |
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CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) |
Policy contract number | 1WDY |
Policy instance | 1 |
Insurance contract or identification number | 1WDY | Number of Individuals Covered | 114 | Insurance policy start date | 2017-05-01 | Insurance policy end date | 2018-04-30 | Total amount of commissions paid to insurance broker | USD $29,229 | Total amount of fees paid to insurance company | USD $13,805 | Are there contracts with allocated funds for individual policies? | 0 | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $974,285 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Amount paid for insurance broker fees | 13765 | Additional information about fees paid to insurance broker | WHOLESALER FEE | Insurance broker organization code? | 5 | Commission paid to Insurance Broker | USD $29,229 | Insurance broker name | WORTHINGTON CAPITAL GROUP |
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CAREFIRST BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 47058 ) |
Policy contract number | 1WDY |
Policy instance | 1 |
Insurance contract or identification number | 1WDY | Number of Individuals Covered | 117 | Insurance policy start date | 2015-05-01 | Insurance policy end date | 2016-04-30 | Total amount of commissions paid to insurance broker | USD $27,097 | Total amount of fees paid to insurance company | USD $18,711 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Other welfare benefits provided | HEALTHY BLUE | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $903,222 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $27,097 | Amount paid for insurance broker fees | 18711 | Additional information about fees paid to insurance broker | NEW BUSINESS BONUS, NON-MONETARY INCENTIVE AND WHOLESALER FEE | Insurance broker name | WORTHINGTON CAPITAL GROUP |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 712049 |
Policy instance | 1 |
Insurance contract or identification number | 712049 | Number of Individuals Covered | 158 | Insurance policy start date | 2014-05-01 | Insurance policy end date | 2015-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $1,116,040 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 712049 |
Policy instance | 2 |
Insurance contract or identification number | 712049 | Number of Individuals Covered | 166 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $976,640 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | |
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CAREFIRST BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 47058 ) |
Policy contract number | 0HMS |
Policy instance | 1 |
Insurance contract or identification number | 0HMS | Number of Individuals Covered | 109 | Insurance policy start date | 2013-05-01 | Insurance policy end date | 2014-04-30 | Total amount of commissions paid to insurance broker | USD $4,390 | Total amount of fees paid to insurance company | USD $45 | Are there contracts with allocated funds for individual policies? | No | Are there contracts with allocated funds for group deferred annuity? | No | Are there contracts with allocated funds for types other than group deferred annuity or individual? | No | Contract purchased, in whole or in part, to distribute benefits from a terminating plan | No | Contracts With Unallocated Funds Deposit Administration | 0 | Are there contracts with unallocated funds for contracts of type immediate participation guarantee? | No | Are there contracts with unallocated funds for contracts of type guaranteed investment? | No | Are there contracts with unallocated funds for contract types other than deposit administration, immediate participation guarantee or guaranteed investment? | No | Health Insurance Welfare Benefit | No | Dental Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | No | Life Insurance Welfare Benefit | No | Temporary Disability Insurance Welfare Benefit | No | Long Term Disability Insurance Welfare Benefit | No | Unemployment Insurance Welfare Benefit | No | Were dividends or retroactive rate refunds paid in cash? | No | Were dividends or retroactive rate refunds paid as a credit? | No | Welfare Benefit Premiums Paid to Carrier | USD $87,800 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,390 | Amount paid for insurance broker fees | 45 | Additional information about fees paid to insurance broker | NON-MONETARY INCENTIVE AMOUNT | Insurance broker name | WORTHINGTON CAPITAL GROUP |
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CAREFIRST BLUECROSS BLUESHIELD (National Association of Insurance Commissioners NAIC id number: 47058 ) |
Policy contract number | 0HMS |
Policy instance | 1 |
Insurance contract or identification number | 0HMS | Number of Individuals Covered | 111 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $3,999 | Total amount of fees paid to insurance company | USD $47 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $79,785 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $3,999 | Amount paid for insurance broker fees | 47 | Insurance broker name | WORTHINGTON CAPITAL GROUP |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 712049 |
Policy instance | 2 |
Insurance contract or identification number | 712049 | Number of Individuals Covered | 166 | Insurance policy start date | 2012-05-01 | Insurance policy end date | 2013-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Dental Insurance Welfare Benefit | No | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $1,009,948 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Insurance broker organization code? | 3 | Insurance broker name | |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 712049 |
Policy instance | 2 |
Insurance contract or identification number | 712049 | Number of Individuals Covered | 166 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $961,587 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) |
Policy contract number | OHMS |
Policy instance | 1 |
Insurance contract or identification number | OHMS | Number of Individuals Covered | 114 | Insurance policy start date | 2011-05-01 | Insurance policy end date | 2012-04-30 | Total amount of commissions paid to insurance broker | USD $4,392 | Total amount of fees paid to insurance company | USD $46 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $87,823 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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UNITEDHEALTHCARE INSURANCE COMPANY (National Association of Insurance Commissioners NAIC id number: 79413 ) |
Policy contract number | 712049 |
Policy instance | 2 |
Insurance contract or identification number | 712049 | Number of Individuals Covered | 168 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $0 | Total amount of fees paid to insurance company | USD $0 | Health Insurance Welfare Benefit | Yes | Vision Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $993,581 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No |
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CAREFIRST BLUECHOICE (National Association of Insurance Commissioners NAIC id number: 96202 ) |
Policy contract number | OHMS |
Policy instance | 1 |
Insurance contract or identification number | OHMS | Number of Individuals Covered | 111 | Insurance policy start date | 2010-05-01 | Insurance policy end date | 2011-04-30 | Total amount of commissions paid to insurance broker | USD $4,300 | Total amount of fees paid to insurance company | USD $45 | Dental Insurance Welfare Benefit | Yes | Welfare Benefit Premiums Paid to Carrier | USD $86,009 | Did the insurance company fail to provide any information necessary to complete Schedule A of form 5500? | No | Commission paid to Insurance Broker | USD $4,300 | Amount paid for insurance broker fees | 45 | Additional information about fees paid to insurance broker | NON-MONETARY INCENTIVE AMOUNT | Insurance broker organization code? | 3 | Insurance broker name | WORTHINGTON CAPITAL GROUP LTD |
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